The potential of assessment based on the WHO framework of intrinsic capacity in fragility fracture prevention.

Autor: Astrone P; Subacute Care Unit, Azienda Socio Sanitaria Territoriale (ASST) Lodi, Lodi, Italy. paolo.astrone@outlook.com., Perracini MR; Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.; Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil., Martin FC; Emeritus Geriatrician and Professor of Medical Gerontology, Population Health Sciences, School of Life Sciences and Population Health, King's College London, London, UK., Marsh DR; Emeritus Professor of Orthopaedics, University College London, London, UK., Cesari M; Geriatric Unit, Fondazione IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy.; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Jazyk: angličtina
Zdroj: Aging clinical and experimental research [Aging Clin Exp Res] 2022 Nov; Vol. 34 (11), pp. 2635-2643. Date of Electronic Publication: 2022 Jul 13.
DOI: 10.1007/s40520-022-02186-w
Abstrakt: The risk of falls associated with population ageing and the burden of chronic diseases increase the risk of fragility fractures. Globally, a large increase in the numbers of people sustaining fragility fractures is predicted. The management of highly vulnerable older persons who present and/or are at risk of fragility fractures is challenging given their clinical complexity and the fragmentation of the healthcare services. Fragility fractures frequently result in reduced functional ability and quality of life. Therefore, it is essential to implement person-centered models of care to address the individual's priorities and needs. In this context, the multidimensional construct of intrinsic capacity, composed of the critical functions on which the individual's functional ability rely, becomes of particular interest.In this article, the potential of current models to meet the global challenge is considered, particularly where healthcare systems are less integrated and poorly structured. It then describes how assessment of intrinsic capacity might provide the clinician with a holistic picture of an older individual's reserves before and after a fragility fracture and the implications of implementing this approach based on the construct of intrinsic capacity in healthcare systems, in both well-developed and low-resourced settings. It suggests that optimization of intrinsic capacity and functional ability is a credible conceptual model and might support a generally feasible approach to primary and secondary fracture prevention in older people.
(© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE